Local City Search for Psychiatrists, Psychologists, Therapists, Counselors and Mental Health Treatment CentersMS. JENNIFER I KOOP OLSTA PHD
Clinical Neuropsychologist
Milwaukee, Wisconsin
Provider NPI: 1053362897
Provider Information:MS. JENNIFER I KOOP OLSTA PHD
Gender: F
Not Sole Proprietor
Practice Location:
9200 W WISCONSIN AVE FROEDTERT & MED COLLEGE CLIN - WEST MILWAUKEE, WI 53226 US
Tel: 414-805-5660 Fax: 414-259-9012
Business Mailing Address:
9200 W WISCONSIN AVE FROEDTERT & MED COLLEGE CLIN - WEST MILWAUKEE, WI 53226 US
Tel: 414-805-5660 Fax: 414-259-9012
Entity Type: Individual
Taxonomy:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 103G00000X | Behavioral Health & Social Service Providers Clinical Neuropsychologist | WI | 2558 |
Other Provider Identifiers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 1053362897 | WI | 05 | |
| 39149800 | WI | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
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